Pediatric Otolaryngologist - Scientist
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Robert Heinlein

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"The supreme irony of life is that hardly anyone gets out of it alive."
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Lunch Order

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GO FOR LUNCH, REPEAT, GO FOR LUNCH.
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4 public comments
GuuZ
14 days ago
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:)
Covarr
20 days ago
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Shouldn't a lunch order have details, such as what lunch is being ordered?
Moses Lake, WA
astw56
19 days ago
It seems they're in the mood for Russian today, Covarr.
Covarr
19 days ago
I wish there were a way to like replies.
satadru
18 days ago
Time to put in a feature request!
ameel
20 days ago
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:D
Melbourne, Australia
alt_text_bot
20 days ago
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GO FOR LUNCH, REPEAT, GO FOR LUNCH.

Of Course The Simpsons Took The Piss Out Of Trump’s First 100 Days Quite Brilliantly [Video]

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America’s favourite yellow family have poked fun at the Donald in the past, and they weren’t about to let the mythical ‘first 100 days in office’ landmark pass without firing a shot or two.

Sean Spicer hanging himself, Kellyanne Conway fleeing in fear, Steve Bannon and Jared Kushner throttling each other, Ivanka as a Supreme Court judge – it’s all there.

Hit it:

Seven percent of the way…

[source:newsau]

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Survivorship Bias

5 Comments and 24 Shares
They say you can't argue with results, but what kind of defeatist attitude is that? If you stick with it, you can argue with ANYTHING.
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FarrelBuch
36 days ago
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Survivorship bias is just the beginning. We humans love stories, particularly about just one person. Alas, only systematic review of ALL the data is the only hope of seeing effects that are not random chance and seeing how big those effects are.
Pittsburgh, PA, USA
CallMeWilliam
36 days ago
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Applies to actively managed funds too, of course.
dukeofwulf
36 days ago
Basically just another lottery.
elwillow
36 days ago
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Applies to jobs search too.
Ottawa, Ontario
alt_text_bot
37 days ago
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They say you can't argue with results, but what kind of defeatest attitude is that? If you stick with it, you can argue with ANYTHING.
Covarr
37 days ago
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I'd rather see speeches about how it's okay not to be a massive success. "Statistically, kids, some of you won't ever make it significantly above the poverty line. But you'll keep going, and raise a family, and when you look back on your life in the end, you'll realize that at least you were a more likable person than Justin Bieber.
Moses Lake, WA
sfrazer
36 days ago
Such a low bar, and most of reddit will still fail to meet it.

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There's a compromise bill to keep the notification bar but at least charge the battery.
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2 public comments
Covarr
64 days ago
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I think the real question is, who would want to move to a country with only 3G service and no LTE?
Moses Lake, WA
endlessmike
61 days ago
Maybe he was just somewhere with poor service, which makes some sort of sense since there's no wifi available either
alt_text_bot
64 days ago
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There's a compromise bill to keep the notification bar but at least charge the battery.

The occasional surgeon

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On the Forbes website, Dr. Robert Pearl writes

"When I was selected to become CEO of The Permanente Medical Group, the Permanente half of Kaiser Permanente, the time required for my responsibilities forced me to give up doing surgery on a regular basis. But every year since then, during the week between Christmas and New Year’s Day, I have returned to the operating room. The timing works, as the leadership demands become minimal and it’s unlikely I’ll suddenly be needed to fly to another part of the country. It’s a magical time for me, contrasting dramatically with my world as CEO. For several hours each day, my focus is not on millions of Kaiser Permanente members—or, for that matter, on all the complexities of healthcare policy, politics and strategy—but, rather, on a single patient at a time."

Dr. Pearl is a Yale medical school graduate who trained at Stanford and has been board-certified in plastic surgery since 1979. The American Board of Plastic Surgery did not start requiring maintenance of certification every 10 years until 1995.

We do not know what specific surgical procedures he does during his magical time. Is he removing moles, performing reconstructive surgery, or doing facelifts and nose jobs? Do his patients know that he only operates a few days per year? What happens if a wound complication requiring revision surgery arises? Who follows up his patients?

How does he maintain his skills if he only operates one week per year?

The literature does not address Dr. Pearl's unique situation.

A database mining paper claimed cardiac surgeon performance deteriorated after even one day of not doing surgery. I blogged that I didn’t believe it citing many concerns including that a number of unmeasured confounders could have accounted for the small differences in outcomes.

A report prepared for the UK's General Medical Council referenced “return to practice guidelines” from the Academy of Royal Medical Colleges which found few studies about how quickly and why medical skills decline and concluded that an absence of less than three months from practice was probably not significant.

In 2014, Braun et al published a survey of deployed US Army pediatricians, half of whom were away for 6 months or more during which they "infrequently practiced the full range of their pediatric skills." Such deployments led to "a significant decline in perceived comfort with both routine and acute pediatric care."

From the UK GMC report: "Regarding surgical and clinical skills, the disparate evidence on specific skills shows that the majority of subjects assessed for retention of learned skills did not totally [emphasis added] lose the new skill after a set time period."

Notwithstanding the cardiac surgery study mentioned above, surgical skills probably do not fade after a few days or even a few months of inactivity. But operating only one week per year for several years? Quite possible.

When I was a chief of surgery, I would not have given privileges to a surgeon who operates 1.9% of every year.

Would you want the occasional surgeon to perform your operation?
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